Ensuring fair and balanced job plans for O&G roles
Providing new O&G doctors with structured, supportive job plans is essential in maintaining high standards of patient care, clinical continuity, and work-life balance. The guidance on this page outlines the principles for creating effective job plans, ensuring that posts are fair, sustainable and aligned with the Good Medical Practice Guide.
- A timetabled job plan should enable the Consultant to maintain continuity of patient care with their caseload.
- For Consultant posts with resident night shifts, time off before and after night shifts should be clear in the job plan and should neither impinge on clinical care, nor on professional development.
- Consultants should not have to travel between sites more than once in a day.
- Jobs advertised with a special interest should have appropriate PA’s built into the job plan.
Direct Clinical Care/Supporting Professional Activities Split
- For full details of PA requirements, please download our checklist.
- The total number of PAs per week must be clearly stated in a regular timetable, showing clinical duties and allocated Direct Clinical Care (DCC), Supporting Professional Activities (SPA) and time off (which may be used for private practice).
- If annualised, this needs to be shown as the average per week.
- If total job plan is 7 or more PA’s then a minimum of 1.5 SPA’s should be allocated.
- If total job plan is less than 7 PA’s there should be a minimum of 1 SPA.
DCC Time
- England and Northern Ireland: DCC should not exceed 85% of total PAs, of which at least 10% will be clinical administration.
- Wales: DCC will be a maximum of 70% of total PAs, of which at least 30% will be SPA.
- DCC time must be allocated for appropriate ward rounds (e.g. pre and post-operative, and obstetric inpatients).
- MDT’s and ward rounds should be included in DCC’s and activity captured in job plans.
- Other aspects of direct clinical care should be captured during DCC planning, including communications with patients and colleagues, GP advice and related administration.
SPA Time
SPA time covers essential non-clinical activities that contribute to the overall quality of health services. This includes teaching, training, CPD, and other tasks that support long-term service development and professional accountability. SPA’s must be a minimum of 15% of the total PAs.
Examples of SPA activities include:
- Teaching, training, and education
- Continuing Professional Development (CPD), including journal reading
- Clinical governance, audit, and appraisal
- Research and clinical management
- Service development
SPAs should exclude significant NHS responsibilities (e.g., Medical Director, Clinical Director), training roles (e.g., TPD or Dean), and external duties (e.g., examiner, peer assessor, College/Department of Health (DH)/General Medical Council (GMC) work). Trusts may allocate further SPAs for research or specific duties as necessary.
- SPA’s must be minimum 15% of the total PAs, including at least 1 SPA for mandatory training, appraisal, audit and CPD.
Out of Hours (OOH) Work
Out of Hours (OOH) work is essential to patient safety, and job plans should carefully define limits on OOH duties to avoid consultant burnout.
- Job plans should include a maximum of 3 PAs per week OOH, i.e. 5pm-9am and weekends, either predictable / unpredictable on call, or resident shifts (job plans may be approved with up to 4 OOH PA’s in those trusts who are actively planning to reduce this number).
- All OOH (non-resident) on-call work should be Category A.
Obstetrics On Call
For posts covering obstetrics OOH, it’s important that consultants have dedicated time on the labour ward during regular working hours.
- Posts should allocate at least 0.5 PA per week (or equivalent in annualised job plans) on labour ward during normal daytime working hours (8am-5pm).
- It should be made clear within the job plan that the Consultant is not on duty for the labour ward whilst covering services on another site or doing private practice.
- Consultants should not be scheduled for labour ward whilst being timetabled for other clinical duties, such as antenatal or gynaecology clinics.
Gynaecology On Call
- The recommended number of gynaecology theatre lists is at least alternate weekly, but on call gynaecology capabilities should be competency based.
- Competency should be maintained in laparotomy, diagnostic laparoscopy, management of miscarriage and ectopic for OOH work.
- The job plan should specify how competency will be maintained in emergency gynaecology, or include a description of how patient safety will be assured. For example, individualising their gynaecology emergency cover or having a ‘second on’ rota for gynaecology.
- Trusts need to consider regional network models for complex emergency gynaecological surgery.
Support and Resources
To support you in this process, we have created the following resources: